Provider Demographics
NPI:1063708717
Name:PARRY-BIRNSTILL, LISA R (FNP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:PARRY-BIRNSTILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:R
Other - Last Name:BILYEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:8 DELAY STREET
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-8014
Mailing Address - Country:US
Mailing Address - Phone:203-797-8330
Mailing Address - Fax:
Practice Address - Street 1:900 ROUTE 376 STE H
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6496
Practice Address - Country:US
Practice Address - Phone:845-204-9500
Practice Address - Fax:845-204-9499
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336793-1364SF0001X
CT6298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03715148Medicaid